A variety of ocular surgery requires the drainage or removal of retinal fluid. In particular, subretinal fluid (“SRF”) is drained during surgical repair of retinal detachment (“RD”) in scleral buckling surgery, pars plana vitrectomy, or pneumatic retinopexy. More recently, surgical procedures have been developed to inject fluids and stem cells under the retina to treat certain degenerative retinal conditions.
RD is a condition where intraocular fluid passes under the retina from a hole within the retina. The intraocular fluid enters a space between the retina and the choroid. Once between the retina and the choroid, the SRF lifts up the retina, causing the retina to come away from its normal attachment to the choroid at the back of the eye. RD can lead to irreversible blindness in the patient if the retina is not fixed in a timely manner. In certain other conditions when there is inflammation in the eye, the retina may have SRF develop under the retina without a hole. The end result is the same where it results in irreversible blindness.
RD may be conventionally addressed using scleral buckling, pars plana (“PP”) vitrectomy, or pneumatic retinopexy. Scleral buckling includes the application of a silicone sponge, rubber, or semi-hard plastic to the exterior of the sclera by the operating professional. Conventionally, the buckling element is left in place permanently. The buckling element compresses the sclera toward the center of the eye, relieving traction on the retina, allowing the RD to settle against the wall of the eye.
Pars plana vitrectomy includes the removal of vitreous fluid from the vitreous chamber of the eye behind the lens. The vitreous fluid is conventionally removed through the pars plana adjacent the iris and ciliary body. To fix a RD via the pars plana vitrectomy route disadvantageously involves the penetration of the retina to provide a drainage path of the SRF.
Pneumatic retinopexy includes the introduction of a gas bubble having a different density than the vitreous fluid in the eye. The buoyancy of the gas bubble in the vitreous fluid enables the gas bubble to apply a force to the detached portion of the retina and urge the retina back into the proper position. More importantly, the gas bubble closes the retinal hole thereby preventing further entry of vitreous fluid under the retina. The retina is then secured via cryopexy, photocoagulation, or other fixation method.
In each procedure, the removal of the SRF allows the proper placement of the retina apposed against the inside of the back of the eye and allows the retina to be more reliably secured in place. Incomplete removal of the SRF results in the inability of the retina to function leading to blindness. Additionally, any further damage to the retina can introduce additional holes or tears through which intraocular fluid may reenter the space behind the retina, resulting in an increased risk of RD. Therefore, a device and method for the reliable and complete removal of SRF from behind the retina is desirable.